Mr. D is a 90-year-old man who was admitted to the hospital with complaints of nausea, vomiting, left arm pain, and chest pain. An electrocardiogram (ECG) is performed, and he is diagnosed as having a myocardial infarction. Mr. D has a long history of comorbidities including hypertension, diabetes, and congestive heart failure (CHF). With this in mind, the physician asks Mr. D if he wants life-sustaining measures taken (e.g., CPR, mechanical ventilation, etc.) should he experience cardiopulmonary arrest. Mr. D tells the physician that he wants all measures taken to save his life.
Imagine that you are the nurse assigned to provide care to Mr. D, and address the following:
Considering Mr. D's advanced age, what are the benefits/risks associated with providing life-sustaining measures?
What factors should you consider based on the Mr. D's age and health history?
If Mr. D were your family member, how would you respond to his decision?
Full Answer Section
Risks:
- Life-sustaining measures can be uncomfortable or painful for patients.
- Life-sustaining measures can prolong suffering.
- Life-sustaining measures can be expensive.
- Life-sustaining measures may not be successful in saving a patient's life.
Factors to Consider Based on Mr. D's Age and Health History
- Mr. D's advanced age: Mr. D is 90 years old, which is considered to be an advanced age. Older adults are at increased risk for complications from life-sustaining measures.
- Mr. D's comorbidities: Mr. D has a history of hypertension, diabetes, and CHF. These comorbidities increase the risk of complications from life-sustaining measures.
- Mr. D's wishes: Mr. D has told the physician that he wants all measures taken to save his life.
How I Would Respond to Mr. D's Decision if He Were My Family Member
If Mr. D were my family member, I would respect his decision to have all measures taken to save his life. I would also want to make sure that he understood the benefits and risks of life-sustaining measures. I would also want to talk to him about his goals of care and what is important to him at this stage of his life.
Conclusion
The decision of whether or not to provide life-sustaining measures to Mr. D is a complex one. There are both benefits and risks to consider, and it is important to weigh these factors carefully. Mr. D's age and health history are important factors to consider, but it is also important to respect his wishes.